Peri-Implant Behavior of Sloped Shoulder Dental Implants Used for All-On-Four Protocols: An Histomorphometric Analysis in Dogs

Abstract: The aim of this study was to evaluate the soft tissue thickness and marginal bone loss around dental implants with sloped micro-threaded shoulder (30° angle) in comparing with conventional design, inserted 30° degrees angulated in post extraction sockets and immediate loaded with temporary prosthesis simulating the all-on-four protocol. Materials and Methods: Six fox hound dogs received forty-eight post extraction dental implants with the different diameter and length (Medentika, Germany), but with different neck configurations. Two group of implants were inserted 1mm subcrestal. Control group has a micro-threaded neck and the Test group has a sloped microthreaded neck. Immediate loading was applied using a constructed metallic structure. After three months, soft and hard tissue levels were assessed by histomorphometric analysis. Results: The mean soft tissue thickness (STT) was 2.5 ± 0.2 mm for the Control group and 3.3 ± 0.3 mm for Test group (p = 0.036), meanwhile the mean marginal bone loss (MBL) was 1.53 ± 0.34 mm for Control group and, 1.62 ± 0.22 mm for Test group (p \u3e 0.05). Conclusions: Within the limitations of this experimental model in dogs, the findings showed that dental implants with microthreaded and microthreaded sloped necks installed in immediate post extraction sites with immediate load, presented a comparable perimplant tissue behavior

COVID-19, Pathophysiology and Prospects for Early Detection in Patients with Mild Symptoms of The Controversial Virus in Underdeveloped Countries

COVID 19 has spread uniformly across the planet without distinction of hemispheres, borders, or climates. However, underdeveloped countries lack sufficient means to effectively detect and cope with the pandemic. The catastrophic economic situation forces indefinite quarantines to avoid health collapse. The scarcity of massive detection tests has led health personnel, the general population and their rulers to ignorance of the true epidemiological magnitude of SARS-CoV-2. Method: A computerized bibliographic search was performed using the Google search engine of original and review articles indexed by Scopus and WOS, in the PubMed / Medline and Cochrane databases to identify all relevant manuscripts and preprints, notices from professional societies and comments from Experts published from the start of the current epidemic related to mild COVID 19 symptoms. Tools, massive methods for detecting the disease and their low availability in underdeveloped countries were analyzed. Inexpensive and easily accessible methods for testing for the disease were discussed. Result: According to the indexed publications on the incidence of hypoxemia as a symptom and parameter of the evolution of the disease, oxygen saturation of less than 93% was determined as the limit to consider the patient suspected of COVID 19. In addition, it was determined after the analysis of published studies show an average prevalence of anosmia-hyposmia as a mild symptom in 69% of patients infected with COVID 19. Conclusion: Suspected cases of COVID 19 infection could be detected by the presence of its prevalent signs and symptoms. More studies are needed to standardize and validate the postulated screening tests

Implantatna stabilnost i nivo marginalne kosti kod cirkonijum endoosealnih implantata sa mikrostrukturiranom površinom - tromesečna eksperimentalna studija na psima

Background/Aim. The modification of implant surfaces could affect mechanical implant stability as well as dynamics and quality of peri-implant bone healing. The aim of this 3-month experimental study in dogs was to investigate implant stability, marginal bone levels and bone tissue response to zirconia dental implants with two laser-micro-grooved intraosseous surfaces in comparison with nongrooved sandblasted zirconia and sandblasted, high-temperature etched titanium implants. Methods. Implant surface characterization was performed using optical interferometric profilometry and energy dispersive X-ray spectroscopy. A total of 96 implants (4 mm in diameter and 10 mm in length) were inserted randomly in both sides of the lower jaw of 12 Fox Hound dogs divided into groups of 24 each: the control (titanium), the group A (sandblasted zirconia), the group B (sandblasted zirconia plus microgrooved neck) and the group C (sandblasted zirconia plus all microgrooved). All the implants were immediately loaded. Insertion torque, periotest values, radiographic crestal bone level and removal torque were recorded during the 3-month follow-up. Qualitative scanning electon microscope (SEM) analysis of the bone-implant interfaces of each group was performed. Results. Insertion torque values were higher in the group C and control implants (p lt 0.05). Periotest values increased in all the periods in proportion to the extent of microgrooving as follows: the group C > the control > the group B > the group A (p lt 0.05). Radiographic measurements showed minimal crestal bone loss at 3 months for microgrooved zirconia implants (groups C and B) and control implants compared with the group A implants (p lt 0.05). The removal torque values increased with time for all the groups as follows: the group C > the control > the group B > the group A (p lt 0.05). SEM showed that implant surfaces of the groups B and C had an extra bone growth inside the microgrooves that corresponded to the shape and direction of the microgrooves. Conclusion. The addition of microgrooves to the entire intraosseous surface of zirconia dental implants enhances primary and secondary implant stability, promotes bone tissue in growth and preserves crestal bone levels.Uvod/Cilj. Modifikacija površine implantata može uticati na njegovu mehaničku stabilnost kao i na dinamiku i kvalitet periimplantatnog koštanog zarastanja. Cilj ove tromesečne eksperimentalne studije na psima bio je da se ispita stabilnost implantata, nivo marginalne kosti i odgovor koštanog tkiva na cirkonijum endoosealne implantate sa dve intraosealne površine mikrostrukturirane laserom u poređenju sa peskiranim cirkonijum implantatima čija površina nije mikrostrukturirana kao i sa titanijum implantatima čije su površine peskirane i nagrižene visokom temperaturom. Metode. Karakterizacija površine implantata učinjena je optičkom interferometrijskom profilometrijom i analizom energetskog spektra pri difrakciji X-zračenja. Ukupno 96 implantata (prečnika 4 mm i dužine 10 mm) ugrađeno je nasumično i obostrano u donju vilicu kod 12 pasa (lisičara) i podeljeno u četiri grupe po 24: kontrolna (titanijum implantati); grupa A (peskirani cirkonijum implantati); grupa B (peskirani cirkonijum implantati sa mikrokanalima u koronarnoj trećini); grupa C (peskirani cirkonijum implantati sa mikrokanalima duž cele površine). Svi implantati su odmah opterećeni. Meren je obrtni momenat pri ugradnji implantata, vrednosti periotesta, radiografski nivo marginalne kosti i obrtni moment za uklanjanje implantata tokom tromesečnog perioda praćenja. Međuspoj kosti i implantata iz svake grupe ispitivan je kvalitativnom skenirajućom elektronskom mikroskopijom (SEM). Rezultati. Veći obrtni momenat zabeležen je pri ugradnji implantata kod grupe C i kontrolne grupe (p lt 0,05). U ispitivanom vremenskom periodu, vrednosti periotesta uvećavale su se srazmerno obimu mikrostrukturiranja površine i to: grupa C > kontrolna grupa > grupa B > grupa A (p lt 0,05). Radiografskom analizom utvrđen je minimalni gubitak marginalne kosti u trećem mesecu praćenja oko cirkonijum implantata sa mikrokanalima (grupa B i C) i kontrola u poređenju sa implantatima grupe A (p lt 0,05). Vrednosti obrtnog momenta za uklanjanje implantata vremenom su se uvećavale u svim grupama na sledeći način: grupa C > kontrolna grupa > grupa B > grupa A (p lt 0,05). Kod implantatnih površina grupa B i C, SEM je pokazala dodatni rast koštanog tkiva unutar mikrokanala koji odgovara njihovom obliku i pravcu. Zaključak. Formiranje mikrokanala duž cele intraosealne površine cirkonijum endoosealnih implantata povećava primarnu i sekundarnu implantatnu stabilnost, podstiče urastanje koštanog tkiva i održava nivo marginalne kosti

The Relationship Between Infertility, Infertility Treatment, Psychological Interventions, and Posttraumatic Stress Disorder

The number of women diagnosed as infertile continues to grow every year. The psychological impact of the infertility experience has been said to create distress equivalent to that associated with life-threatening illnesses and has been linked with posttraumatic stress disorder (PTSD). Using shattered assumption and stress-buffering theory, this quantitative causal comparative study explored the potential functional relationship between infertility and PTSD. The majority of the (all-female) participants were 24- to 34-year-old college graduates. A 2 X 3 factorial between-subjects ANOVA examined and compared the cause and effect of the independent variables, fertility treatment and psychological intervention, on the dependent variable, PTSD. A multiple linear regression was conducted to understand PTSD symptomology scores. The results revealed that the type of infertility treatment does not impact PTSD symptomatology in medically diagnosed women. However, the main effect of psychological treatment was significant, as was infertility treatment by psychological treatment interaction. Additionally, the impact of fertility problems on the participant\u27s physical health was the highest ranking predictor, which suggests that stress levels in women receiving infertility treatment are equivalent to those in women with cancer, AIDS, and heart disease, as suggested by other researchers. This study has implications for positive social change, in that it may promote better understanding of the psychological impact of infertility and decreased PTSD symptomatology for medically diagnosed infertile women. It opens the door for future research about the effectiveness of psychological intervention, and provides awareness of possible PTSD susceptibility

Determination of essential biomarkers in lung cancer : a real-world data study in Spain with demographic, clinical, epidemiological and pathological characteristics

Background The survival of patients with lung cancer has substantially increased in the last decade by about 15%. This increase is, basically, due to targeted therapies available for advanced stages and the emergence of immunotherapy itself. This work aims to study the situation of biomarker testing in Spain. Patients and methods The Thoracic Tumours Registry (TTR) is an observational, prospective, registry-based study that included patients diagnosed with lung cancer and other thoracic tumours, from September 2016 to 2020. This TTR study was sponsored by the Spanish Lung Cancer Group (GECP) Foundation, an independent, scientific, multidisciplinary oncology society that coordinates more than 550 experts and 182 hospitals across the Spanish territory. Results Nine thousand two hundred thirty-nine patients diagnosed with stage IV non-small cell lung cancer (NSCLC) between 2106 and 2020 were analysed. 7,467 (80.8%) were non-squamous and 1,772 (19.2%) were squamous. Tumour marker testing was performed in 85.0% of patients with non-squamous tumours vs 56.3% in those with squamous tumours (p-value < 0.001). The global testing of EGFR, ALK, and ROS1 was 78.9, 64.7, 35.6% respectively, in non-squamous histology. PDL1 was determined globally in the same period (46.9%), although if we focus on the last 3 years it exceeds 85%. There has been a significant increase in the last few years of all determinations and there are even close to 10% of molecular determinations that do not yet have targeted drug approval but will have it in the near future. 4,115 cases had a positive result (44.5%) for either EGFR, ALK, KRAS, BRAF, ROS1, or high PDL1. Conclusions Despite the lack of a national project and standard protocol in Spain that regulates the determination of biomarkers, the situation is similar to other European countries. Given the growing number of different determinations and their high positivity, national strategies are urgently needed to implement next-generation sequencing (NGS) in an integrated and cost-effective way in lung cancer

RICORS2040 : The need for collaborative research in chronic kidney disease

Chronic kidney disease (CKD) is a silent and poorly known killer. The current concept of CKD is relatively young and uptake by the public, physicians and health authorities is not widespread. Physicians still confuse CKD with chronic kidney insufficiency or failure. For the wider public and health authorities, CKD evokes kidney replacement therapy (KRT). In Spain, the prevalence of KRT is 0.13%. Thus health authorities may consider CKD a non-issue: very few persons eventually need KRT and, for those in whom kidneys fail, the problem is 'solved' by dialysis or kidney transplantation. However, KRT is the tip of the iceberg in the burden of CKD. The main burden of CKD is accelerated ageing and premature death. The cut-off points for kidney function and kidney damage indexes that define CKD also mark an increased risk for all-cause premature death. CKD is the most prevalent risk factor for lethal coronavirus disease 2019 (COVID-19) and the factor that most increases the risk of death in COVID-19, after old age. Men and women undergoing KRT still have an annual mortality that is 10- to 100-fold higher than similar-age peers, and life expectancy is shortened by ~40 years for young persons on dialysis and by 15 years for young persons with a functioning kidney graft. CKD is expected to become the fifth greatest global cause of death by 2040 and the second greatest cause of death in Spain before the end of the century, a time when one in four Spaniards will have CKD. However, by 2022, CKD will become the only top-15 global predicted cause of death that is not supported by a dedicated well-funded Centres for Biomedical Research (CIBER) network structure in Spain. Realizing the underestimation of the CKD burden of disease by health authorities, the Decade of the Kidney initiative for 2020-2030 was launched by the American Association of Kidney Patients and the European Kidney Health Alliance. Leading Spanish kidney researchers grouped in the kidney collaborative research network Red de Investigación Renal have now applied for the Redes de Investigación Cooperativa Orientadas a Resultados en Salud (RICORS) call for collaborative research in Spain with the support of the Spanish Society of Nephrology, Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón and ONT: RICORS2040 aims to prevent the dire predictions for the global 2040 burden of CKD from becoming true

Implants placed in the nasopalatine canal to rehabilitate severely atrophic maxillae: A retrospective study with long follow-up

To assess the survival rate of implants placed in the nasopalatine canal for the rehabilitation of patients with atrophic maxillae and the level of satisfaction of these patients. A retrospective study was performed between 2000 and 2009 of patients with severe atrophy of edentulous maxillae (Cawood and Howell’s class V) rehabilitated with implant-supported prostheses with 1 implant placed in the nasopalatine canal. A preoperative computed tomography scan was obtained of all patients and all surgeries were performed by the same surgeon. The following parameters were assessed: neurosensory status of the anterior palate (using the pointed/blunt discrimination method); implant success rate according to criteria described by Albrektsson et al; patient satisfaction with the prosthetic treatment (using visual analogue scales). Thirteen patients with a mean age of 54.8 years were treated, 5 men and 8 women. Seventy-eight implants were placed: 13 in the nasopalatine canal, 6 in the zygomatic bone, 12 in the pterygomaxillary region, 2 in the frontomaxillary buttress and 45 in other locations. Six patients reported a slight decrease in sensitivity in the anterior palate after surgery, which disappeared in all cases within a few weeks. Two early failures (before prosthetic loading) and no late failures (after prosthetic loading) of nasopalatine implants were recorded, yielding a success rate for these implants of 84.6% after a mean follow-up of 70 months (range 24 to 132 months. High patient satisfaction with the prosthetic restoration was generally achieved in terms of comfort, stability, function, esthetics, and ease of cleaning. Residual bone is associated with the nasopalatine canal, even in patients with severe maxillary atrophy. This canal may be considered a possible location for an anterior implant when rehabilitating atrophic patients using implant-supported prosthese

Randomized clinical study of the peri-implant healing to hydrophilic and hydrophobic implant surfaces in patients receiving anticoagulants

ObjectivesTo compare the peri-implant bone healing between TiZr implants with hydrophilic SLActive and hydrophobic SLA implant surface in patients receiving anticoagulants, to assess the implant survival and success rate, as well as to evaluate whether small-diameter TiZr implants could be used in patients on OAT in order to avoid augmentation procedures. Material and methodsA total of 80 small-diameter tissue-level TiZr implants with SLActive and SLA surfaces were placed in 20 anticoagulated patients, following the split-mouth study design. Implant stability was measured up to the third postoperative month by resonance frequency measurements (RFA). One-year implant survival and success rate were evaluated. ResultsAfter one year, 100% implant survival and success rate were observed. A significant decrease in ISQ comparing to baseline values was noted in the SLActive group from the first postoperative week, and in the SLA group, from the 3rdweek after the surgery. In both groups, a statistically significant decline in ISQ was observed between second and third postoperative week. No significant differences in ISQ values between SLActive and SLA implants were noted, at any time point. ConclusionsTitanium-zirconium small-diameter implants with SLActive and SLA surface predictably achieve and maintain adequate bone tissue integration in patients receiving anticoagulants. OAT appears to influence the bone healing events resulting in lower ISQ in the end of 3-month period in comparison with baseline values, although without compromising implant stability

Two-Center Prospective, Randomized, Clinical, and Radiographic Study Comparing Osteotome Sinus Floor Elevation with or without Bone Graft and Simultaneous Implant Placement

Purpose: To evaluate stability and success rate of hydrophilic nanostructured implants placed via osteotome sinus floor elevation (OSFE) without grafting material or using beta-tricalcium phosphate (beta-TCP), deproteinized bovine bone (DBB), or their combination, and also to assess three-dimensional volumetric stability of endo-sinus bone gained in the aforementioned conditions. Materials and Methods: OSFE with simultaneous implant placement (10-mm long SLActive-BL (R), Straumann, Basel, Switzerland) was performed. Grafting materials were randomly allocated to implant sites, whereas one site was left without graft. Implant stability was measured by resonance frequency analysis over 6 months. Implant success was evaluated after 2 years of loading. Volume of new endo-sinus bone was calculated from CBCT images using 3D Slicer (R) software. Results: A total of 180 implants were inserted into posterior maxilla of 45 patients with 6.59 +/- 0.45 mm of residual bone height, and all remained successful after 2 years. Implant stability steadily increased during healing, without significant difference between groups (p =.658). After 2 years, endo-sinus bone significantly shrank (p lt .001) in all groups (DBB: 66.34%; beta-TCP: 61.44%; new bone formed from coagulum: 53.02%; beta-TCP + DBB: 33.47%). Conclusions: Endo-sinus bone gained after OSFE inevitably and significantly shrinks regardless of whether grafting material is applied or not. Grafting material offers no significant advantage to stability nor clinical success of hydrophilic and nanostructured implants placed simultaneously with OSFE

Human fetal osteoblast behavior on zirconia dental implants and zirconia disks with microstructured surfaces. An experimental in vitro study

ObjectivesTo measure the lateral surface area of microgrooved zirconia implants, to evaluate the cell geometry and cell density of human fetal osteoblasts seeded on zirconia microgrooved implants, to describe the surface roughness and chemistry, and to evaluate the activity of human fetal osteoblasts seeded on zirconia microgrooved disks. Materials and methodsThis experimental in vitro study used 62 zirconia implants and 130 zirconia disks. Two experimental groups were created for the implants: 31 non-microgrooved implants (Control) and 31 microgrooved implants (Test); two experimental groups were created for the disks: 65 non-microgrooved disks (Control) and 65 microgrooved disks (Test). The following evaluations of the implants were made: lateral surface area (LSA), cell morphology, and density of human fetal osteoblasts seeded on implant surfaces. On the disks, surface parameters (roughness and chemistry) and cell activity (alkaline phosphatase - ALP and alizarin red - ALZ) were evaluated at 7 and 15days. ResultsLSA was lower for control implants (62.8mm) compared with test implants (128.74mm) (P lt 0.05). Cell bodies on control surfaces were flattened and disorganized, while in the test group, they were aligned inside the microgrooves. Control group cells showed few lamellipodia, which were attached mainly inside topographical accidents (surface cracks, valleys, and pits). Test group implants presented cells rich in lamellipodia prolongations, attached to the inner walls or to the borders of the microgrooves and in the flat areas between the microgrooves. Cell density was higher in the test group compared with controls (P lt 0.05) Surface roughness and oxygen content increased in test disks samples compared with controls (P lt 0.05). Carbon and aluminum were reduced in disks test samples compared with controls (P lt 0.05), and ALP and ALZ levels were significantly increased on test surfaces (P lt 0.05) at both study times. ConclusionsWithin the limitations of this experimental study, it may be concluded that (i) Roughness is increased and chemical composition enhanced on the surface of zirconia implants with microgrooves. (ii) The LSA of microgrooved zirconia implants is greater and provides more available surface compared with implants of the same dimensions without microgrooves. (iii) Microgrooves on zirconia implants modify the morphology and guide the size and alignment of human fetal osteoblasts. (iv) Zirconia surfaces with microgrooves of 30m width and 70m separation between grooves enhance ALP and ALZ expression by human fetal osteoblasts